Caveat emptor, Issues

Second class citizens, 3rd rate medical care

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Seeing Mr. P’s walking arrival at Thursday night’s meal for the hungry on the grassy roadside of Gladys underscored the fact that although it is annoying and demeaning, it is not being treated as second class citizens that worry’s the homeless, mentally ill, addicted, poor and powerless when they HAVE to deal with the Abbotsford Regional Hospital. Rather, it is the 3rd rate medical treatment that is afforded to ‘second class citizens’. Not simply because one is often sent on ones way without receiving even minimally adequate care or receiving care that complicates or exacerbates the problem, but because the ‘treatment’ one gets at the Abbotsford Regional Hospital can be downright deadly to one’s survival.

If that statement seems less than charitable it is because I have experienced the less than professional ‘care’ dispensed to the homeless and powerless and over the years have watched the toll that the behavior at Abbotsford Regional Hospital has exacted from the homeless community.

I am personally reminded of this fact of life for ‘second class citizens’ every time my neck acts up and I need to have it lanced and go on antibiotics.

This is a result of the time several years ago I went to Emergency to have an infection in/on my neck lanced and the cyst removed. As I say, I could have lived with the doctor’s attitude – if only he had done a proper job and removed all the cyst.

He didn’t, so every once in a while the piece of cyst he didn’t clean out causes an infection which needs to be lanced to drain the pus and other assorted gunk and a course of antibiotics. A process I go to a walk in clinic for, rather than risk a return to Emergency.

In light of the problems and complications the treatment afforded ‘second class citizens’ at Abbotsford Regional Hospital causes I consider myself lucky to suffer what is more of an annoyance than a threat to life or limb.

Last spring (2010) I attended the memorial for Laurie McDonald, a member of Abbotsford’s homeless community who had the misfortune to seek medical attention at the Abbotsford Regional Hospital and Cancer Centre.

She had gone to Emergency several times to seek treatment for balance problems and had been sent away after having been told she was fine.

The next time she had balance problems she was in Saskatchewan and went to a hospital in Swift Current (I believe). Which quickly, after a few tests, sent her to Regina where tests showed her balance problems were caused by a brain tumour. Within days Laurie was in surgery, which was successful. Unfortunately she died of complications.

To be accurate the unfortunate thing about her death was that she had gone to Abbotsford Regional Hospital’s Emergency for over a year about her balance rather than the hospital in Swift Current Saskatchewan.

A disturbing thought/reality is that if Laurie had sought medical treatment in Saskatchewan first, rather than at Abbotsford Regional Hospital, it could well have been a life saving decision.

Mr. P’s walking arrival at the Thursday night dinner was notable because it was not that many weeks ago that Mr. P was unable to walk more than a few steps and appeared to be knocking at deaths door. Over months and weeks he had been repeatedly hauled off by ambulance to Emergency at Abbotsford Regional Hospital. Despite the increasing frequency of his visits to Abbotsford Regional Hospital’s Emergency he just kept getting worse – heading downhill at an increasing rate.

It looked like Mr. P was not long for this world – until he was fortunate enough to be in Mission when he needed to seek medical treatment.

They admitted him to the Mission Hospital for several days, over which time they ran tests to see what was causing his health problems. As a result of the treatment Mr. P received at Mission Hospital he reappeared in Abbotsford bright eyed and bushy tailed. Alive, well and capable of walking to this Thursday night dinner.

Which is why Mr. P’s walking along the road to the dinner on Thursday night called to mind the unacceptable state of affairs at the Abbotsford Regional Hospital – were for ‘second class citizens’ seeking medical care, their best way of achieving good medical care is to catch the Valley Connector to Mission and Mission Hospital or go to the Greyhound station and catch a bus to Saskatchewan.

Municipal, Snafu

Citizens? Ignore ’em.

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““I’m not sure it’s fair to deny this [4633 Sumas Mountain Road] development,” she [Councillor Lynne Harris] said.”

It seems extremely fair to me to withhold council’s rubberstamping of another development on Sumas Mountain until the study on the effects previous developments had on property downhill and downstream is available.

If we are speaking of lack of fairness it seems extremely unfair to: 1) be making this decision without waiting for the IMSP study that would show whether development has negatively impacted property downhill and downstream; 2) that council in prior years routinely rubberstamped developments without studying what effect development had on property downhill and downstream; 3) to sneak the matter back before council for approval after deferring the decision on the development at a meeting attended by those who own property downhill and downstream; 4) to hold a re-vote when one of those who originally voted on the matter wasn’t present – especially given that councillor voted to wait for the report on the effect development has had.

Or perhaps Councillor Harris meant it was not fair to the developer not to rubberstamp (business as usual) the development but to use evidence (the ISMP study) in making the decision on whether to approve the development. Or perhaps Councillor Harris meant it was not fair to put the interests of Abbotsford’s citizens and area residents ahead of the interests of the developer?

“Councillor Lynne Harris said after “serious reflection” away from the “emotion of the table,” she had changed her mind.” So Councillor Harris was unwilling to stand up and face Abbotsford citizens whose property will be negatively impacted by the development in a forthright manner and vote to approve the development, but is quite willing to slither into a council meeting where she would not be facing those whose property will be negatively impacted by the development and sell out the interests of those citizens ?

There are several words that describe the behaviour of Councillor (Et tu) Harris vis-à-vis this development, but there was nothing fair in her betrayal of the residents of the properties downhill and down stream.

In addressing his guileful return before council of the development on Sumas Mountain Mayor Peary attempted to use doublespeak (language that deliberately disguises, distorts, or reverses meaning) to hide the fact that he was once again placing the interests of developers ahead of the interests of the citizens of Abbotsford (notably those property owners who will be negatively impacted by the development).
For example: ” Peary said he only has 30 days to ask for a reconsideration and had he waited for the next meeting, it would have been too late.”

To late for what?

To take advantage of the absence of Councillor Ross who was not a supporter of approving the development before the ISMP study was complete?

To have the development approved before the ISMP study provided evidence to support the position of property owners downhill and downstream that development on the mountain has negative effects upon them and their property is available?

Why else the rush to decision? As Mayor Peary himself acknowledged when he stated “We would just be reconsidering it in February…”, the decision was due for reconsideration next month (February) – hardly an unreasonable delay.

Or for example: “Peary told The News that the watershed is 1,500 hectares in size, and the 65-unit townhouse development is “a tiny dot” on it.”

What does the size of the watershed have to do with anything? The important point is that “tiny dot” that is the 65-unit townhouse development is right above the “tiny dots” that are the properties of Abbotsford citizens.

How about: ” What’s more, he [Mayor Peary] said city staff assure him that water detention requirements in the development will mean there will be less runoff from the developed land.”

Would this be the same staff who assured citizens the Abbotsford Entertainment and Sports Complex would make a profit and not be a black hole consuming millions of taxpayers dollars?

“… less runoff from the developed land.” Less runoff than what? The floods currently hitting Australia? What is a little more flooding, eh Mayor Peary? Given his drive to have the development approved at any cost the mayor would not want to remember that just a few years ago a “little more flood” would have had the Fraser River breeching its dikes and pouring into Abbotsford.

Contrast Mayor Peary’s doublespeak with the words of Councillor MacGregor who demonstrated a clear grasp of the situation when he stated ““We need to see this report. … we need to wait.””

I would suggest that Mayor Peary needs to remember that his duty of care is owed to the citizens of Abbotsford and not to developers, or wealthy citizens purchasing a professional hockey team, et cetera. But…… given the mayor’s behaviour since he took office and the manner in which he snuck this matter back before council when the timing would ensure that the development was approved – reminding the mayor of the duty of care he owes Abbotsford’s citizens would be a waste of breath.

Poverty

The Whole Tooth

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Finally, I remembered!

I had been trying to remember since late August to contact the Dental Clinic at the Abbotsford Food Bank to make an appointment to have a small cavity taken care of before I have another tooth deteriorate to the point it needs to be extracted.

Poverty is hard on teeth. Bad teeth not only cause severe appearance problems, they also have health consequences; health consequences that can be life threatening and require hospitalization.

Before you dismiss ‘severe appearance problems’ consider the cost to both society and a gentleman I met while he was attending the Triangle Resources program. He had worked hard at getting sober and remaining sober and was going to Triangle in preparation for finding a job. His teeth were in such terrible condition that when he spoke, but especially when he smiled (which he did fairly often then), … his teeth were so ugly it was off putting.
Looking for a place to rent, looking for a job, his teeth gave the people he was meeting a terrible impression and he kept getting No – until his spirit was wounded to the point he slipped back into drug use and homelessness.

I have known those whose teeth worsen to the point they abscess and cause a blood infection. Those to whom this happens end up in hospital on IV antibiotics to fight the infection, some are so bad they need dental surgery.

One of the sick ironies of the income assistance system is that it easier to get help to get all your teeth pulled and dentures than it is to get access to dental care.

Suddenly finding yourself homeless and witnessing the pain and problems, the carnage, bad teeth cause … well you live in dread of having any dental problems – and if you did have dental problems you lived in pain until the problem reached the point of a health problem requiring hospitalization.
At least I lived in dread of having any dental problems.

Dread – until the dental clinic at the food bank opened and poverty stopped being a barrier to dental care.

I remember thinking ‘that is a good idea’ when Dave told me they would soon open a dental clinic at the Food Bank and to let people know. When an old filling caused a tooth to break my thinking about the dental clinic changed to ‘great idea, something desperately needed in this community, cannot open soon enough’. Funny the effect need can have on one’s opinion of something.

Fortunately the dentist was able to clean up and save that tooth.

I was not so fortunate with the next tooth to break around an old filling. There was no way to save the tooth and it had to be extracted. The extraction itself was not nearly as traumatic as the mental trauma of no longer having “all my teeth”. On the positive side was the fact I avoided a lot of pain, infection, illness and a hospital visit.

While they were taking X-rays of my teeth as part of evaluating what to do about the broken tooth they found one of my wisdom teeth was rotten and in need of extraction; they also found a small cavity in another tooth.

I agreed to come in on a Saturday so that dental students out from UBC could get some hands on, real world experience as a way for me to pay forward the care being given my teeth.

LOL – and real world experience they did get. That wisdom tooth had been in my mouth for decades and it did not want to leave. The upside was that they had administered the long lasting anaesthetic (and a goodly amount as well); the downside was watching as heavy steel tool after tool went into my mouth – and came out bloody, listening to the conversation/coaching on the best way to break the tooth into quarters, watching (feeling) the strain as they struggled to wrestle the first piece out.

Blackly humorous was watching/eavesdropping as the local dentist explained to the student about not prescribing pain medication to the clinics clientele (many of who have addiction problems). Hey, after over an hour in that chair … you either found the humour in the situation or wallow in feeling sorry for yourself.

The really fortunate thing is that the freezing lasted long enough to get home and get several doses of acetaminophen and ibuprofen before the freezing wore off.

During the summer I had the opportunity to get a second teeth cleaning. It was a long time in the chair and I (shudder) found myself wondering how long it would have been if there had not been a first cleaning (itself a long session).

Humans are strange. The threat of cavities and losing teeth lacked the motivational power that the thought of having to face a dental hygienist with teeth made dirtier because I did not honour their work by looking after my teeth. Thus motivated I brush daily and floss several times a week.

And as I brush/floss I wonder how many others are taking good care of their teeth because a dental hygienist donated their time to clean those teeth?

Since that cleaning in August and being told to book an appointment to have the small cavity taken care of while it is still a small cavity, I have been trying to remember to get in touch with the clinic on Monday. Monday since this is the one day a week the scheduler who books the appointments is in the office.

In a Duh! moment as I was entering the dental appointment into my phone’s calendar I realized that in order to have remembered to make an appointment in a more timely manner I should have put making an appointment into the phone’s calendar – sort of an appointment to make an appointment.

The fortunate thing for me on a personal basis is that I should be able to have this cavity taken care of before it costs me another tooth.

On the unfortunate side of things is that the dental professionals do not get to see the effect their time and skills has on the patients of the dental clinic.

Such as the gentleman speaking about how wonderful it was to eat without pain for the first time in years. Or those who were looking forward to getting dentures now that their dental issues had been addressed and they could get dentures. Or see how happy/proud they are when they get dentures and not only are they able to eat and chew more than soups and other soft foods but see, every time they look in a mirror, the improvement dentures make to their appearance.

The dental professionals don’t have people coming up to them, giving them a big smile, pointing to their teeth and saying ‘check this out’ after having (for many if not all) the first visit of their lives with a dental hygienist to clean their teeth. The dentists and hygienists don’t see the increase in people brushing their teeth or asking for toothpaste and/or a toothbrush so they can brush their teeth. See the effect on demeanour and self esteem that having more presentable teeth brings about.

They donate their time and do all this work but don’t get to hear their patients talking to each other about how great it is to have had a dental problem taken care of or to have had their teeth cleaned. Nor do they see their patients telling others with dental problems that they have to go to the dental clinic where, not only will their dental problems be taken care of but they will be treated like ‘real human beings.’

They donate their time and do all this work – and really don’t get a appreciation of the effect their efforts have on those who, without the donation of time and skills by this group of dental professionals, would be unable to get the dental care so badly needed. Nor do the professionals get a true understanding of how much their work is appreciated by their patients.

In speaking of those whose work at the dental clinic has such and effect on people’s lives I would be most remiss if I did not speak of Lala, Keeper of the Sanatorium, whose skill and knowledge keeps the clinic, with its diverse cast of dental professionals and patients functioning.

On behalf of all the patients I offer thanks for 2010 and wish all a Happy and Prosperous (and Skillful) 2011.